NPIMap

Organization Active NPI

McDowell County Commission on Aging, Inc.

  • In Home Supportive Care Agency
  • Welch, WV
National Provider Identifier
1376818526
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
FE271147 Issued in WV
Legal business name
MCDOWELL COUNTY COMMISSION ON AGING, INC.
Practice address
725 Stewart St
Welch, WV 24801-2125
Phone
(304) 436-6588
Fax
(304) 436-2006
NPI assigned
Mar 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lisa E Sanderson
Title
Executive Director
Phone
(304) 436-6588

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X FE271147 WV Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

725 Stewart St
Welch, WV 24801-2125

Mailing address

725 Stewart St
Welch, WV 24801-2125
Phone (304) 436-6588

Other identifiers 2

IdentifierTypeStateIssuer
1134348253OtherWVMEDICAID WAIVER
1316166432MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
McDowell County Commission on Aging7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

725 Stewart St
Welch, WV 24801
Phone (304) 436-6588

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1376818526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 STEWART ST",
            "city": "WELCH",
            "state": "WV",
            "postal_code": "248012125",
            "telephone_number": "304-436-6588",
            "fax_number": "304-436-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 STEWART ST",
            "city": "WELCH",
            "state": "WV",
            "postal_code": "248012125",
            "telephone_number": "304-436-6588",
            "fax_number": "304-436-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDOWELL COUNTY COMMISSION ON AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "SANDERSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-436-6588",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WV",
            "license": "FE271147",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER",
            "identifier": "1134348253",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316166432",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Welch, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.